Fees for transfering files

Recently i have been told that to transfer your medical files to another doctor or another medical clinic, there is a fee to do that. my sister in law in Adelaide had to pay $25.00 to do so.

Is this legal? Why a fee? Any thought on that?

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Fees could be justified as long as the cost is reasonable and reflects the real costs of the seding party.

Unfortunately in Australia patients don’t own their own records (maybe the government should legislate that patients own their own records as they/government on the patients behalf has paid for them and therefore should be the property of the patient)


https://www.findlaw.com.au/articles/1086/how-can-i-get-a-copy-of-my-medical-record.aspx

If they did, they could ask for them and hand them to a new practioner.

Hopefully with MyHealth Records (see the MyHealth Records mega thread on this forum), this may avoid such costs in the future as the imoortsnt records could be centralised.

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Many thank fior your reply.

I never knew that your medical records don’t belong to you.
I think it is quite outrageous to pay for your own files. But as you said it needs te be legislated. Even that doesn’t stop medical centres from charging a fee I suppose.

Yes My Health records could work in that instance but personally am not too keen as to the long term prognosis of its potential usage.

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That is an interesting aspect for MyHealth record without amended legislation. If a ‘GP’ (broadly defined to include clinics, surgeons, hospitals, et al) owns your medical record, and each ‘GP’ uploads to MyHealthRecord there could be a turf war for ownership and payment to produce the record for the patient.

Can GP1 or GP2 or GP3 thus deliver all the GPs records? Do ‘GPs’ have to sign away their ownership to participate in MyHealthRecord? I would expect they would push back to preserve their ‘rights’ because it is not often anyone willingly gives up their $33 including GST (or more) from the goodness of their hearts.

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Without researching it I have a vague memory that doctors’ medical files are considered like ‘art’ and therefore viewed as belonging to the creator.

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Probably not. Without substantial changes to the legislation and improbable investment in systems, MyHealthRecord will never contain more than a limited subset of a patient’s information. Certainly not a full history. Most of the records will remain with medical practices.

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It would do and especially when MyHealth states:

'All the copyright and other intellectual property rights subsisting in this website and material contained on this website are owned by the Australian Digital Health Agency or third parties, and are protected by the laws of Australia.

You may download, display, print and reproduce the whole or part of this website in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only for non-commercial purposes and you retain this copyright notice and all disclaimer notices as part of that reproduction.

Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved. Requests and inquiries concerning reproduction rights for this website should be sent to the Communications Branch, Australian Digital Health Agency via the contact form.

A key issue for the Australian Digital Health Agency is accuracy of the information it publishes. If you are permitted to publish a version of any part of this website you must ensure that you publish the latest version.’

This somewhat olfer article also contains some relevant information:

It notes that there is a partial ownership shift towards the patient (compared to the past), however, this is possibly only in relation to use and management of the information rather than it IP ownership where it exists.

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Indeed, an interesting discussion as to what belongs to whom. But as Bianca said above the shift will be toward the patient. It will be very interesting to see how it shapes up.

Now if it belongs to ADHA,(Australian Digital health Agency) how do I fit in that
 and what the doctor has to say about all that?

Can I download my files and keep them or give them to a doctor in if he/she wants them?It seems to me the new doctor has a commercial advantage no?

On the other hand the new doctor could also download my files from the central data.
And the meantime they make us pay thinking that all the info belongs to them.

But after all
Why do they have ownership tho? Who says?

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I see this is an old thread but new to me today so voicing my annoyance. I want to change Dr’s so filled in all the paper work, they rang to say my previous Dr wont transfer files unless I pay $35, I had only been with them for about 12 months and visited maybe 3 times, I had to pay to get files transferred to them previously. Why do we have to pay so much when all it takes is the tough of a button to email files for patient. It seems quite outrageous, a bit like the booking fees we used to have to pay for air travel which have been outlawed now. Surely someone needs to look at this charge that we are made to pay.

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I cannot speak for any or all clinics but I am aware of one where the doctor one normally sees ‘owns’ the patient’s records, and that doctor is the one responsible for packaging those records to forward on. Thus it could be that in the general case it is a doctor’s time, not the office staff’s, or it could be some of each.

Considering many clinics charge more than 2X the medicare rebate for 10-15 minutes ($80+ locally), that fee, while bothersome and perhaps even questionable, may reasonably account for the time spent.

Many GP’s will also charge for refilling a script even if no consultation is required because it requires their time, and ‘billable hours’ determines their income.

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Back in the day they simply mailed on or in a couple of examples handed my partner the large folders from the shelving behind the counter of the surgery. Armed with folders for self, partner, and children she made her way to the next town with all and sundry. No need to sign or have authority for any. Everyone knew who was leaving town and school each week. Life outside of the big smoke. :+1:

This all worked Ok ten years back.
Somewhere between digital record management systems being the norm and external providers attempting to monetise patient records this all changed. More recently 2015 I made the change between towns again. I required a formal request from the new practice in writing, and to provide my own written authority. There was no fee, but the old practice simply condensed all of their treatments to a two page computer summary. All the prior paper records from 30 years plus were gone in their digitalisation, we don’t keep paper records any more.

It’s far from perfect. I’d wonder if what you paid for is worth the fee, although there is obviously as @PhilT suggests a time cost in checking and providing the record.

P.S.
I had to sit for a very long consult subsequently with the new Doctor and reconstruct an entire medical history from memory. We deserve better IMHO.

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I totally sympathise with you. I do not believe time is much of problem. It is just another way to make money.

Why don’t you ask a copy of you tests
Xrays etc
at the time. medical practice have to give it to you. They do for me. If I change doctor I ask my new doctor to make a photocopy and I keep the original. SO that you always have a copy of your history. No need to ask anything. Keep a record of your meds and the rest is not too hard. Unless you have some very serious conditions
and I even feel you are entitled to ask your doctor for a report
 May be I am wrong. Some medical practice will gladly forward to your email whatever you require. They did for me no question asked really.

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Many professionals charge for their time and charge when one requests a document to be sent. Think lawyers, accountants, consulting professionals etc. Doctors are no different as compiling and checking before sending can take time.

And as they say, time costs money. Why?.. the time taken to compile, check and send could have been spent otherwise making money. In the case of a doctor, who would likely check records being sent if support staff pulled them, it would be seeing another parient.

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Somewhat different.

Our GP’s clinic had a notice on the wall in the “waiting room” stating that if patients fail to keep an appointment, they may be charged for a consultation.

What an absolute joke when the GP’s are rarely ever on time, and often 30 minutes or more late, so they could easily see another patient or two.

I suspect it was initiated by the most senior GP, who when the individual GP’s had flyers at the reception desk advising their latest fees a few years ago, he advised that he would not bulk bill anyone based on his lifetime of knowledge and experience, and stated that anyone who was not happy with that was welcome to request their records to go elsewhere.

No mention of any applicable charges.

On one occassion, I noticed a large stack of Advanced Health Care Program forms on the reception desk that he had signed, and I wondered if the patients were actually aware that they were participating.

Hippocratic Oath or hyprocrisy?

I doubt very much the Dr’s do the sending, the admin do this part as they should, I wouldn’t expect the Dr to take the time out to be dealing with patient files, that’s what they pay their staff for. Funnily enough when I got the invoice for file transfer I had someone else’s information not mine, their name, DOB and Medicare number, seemed I wasn’t the only one transferring files, hopefully my details weren’t sent to the other person. The person on the front desk dealt with the payment and advisement of error in details sent, doubt the Dr will even notice I am gone.

They are the doctor’s files and not the staff. The staff may compile them, but any competent doctor will review and check the files before sending. The last thing they will want to be is front page news by accidentially releasing one patient’s files to another. If this happens, the buck stops at the doctor as it is the doctors files and their responsibilities.

Doctors will also review what has been documented to ensure it doesn’t contain any information which they don’t want released such as a private and personal conversation between doctor and patient,. These may not be medically related but recorded for future reference, and these records provide a flag to check well being of the parient at future consultations. An example might be some personal event (death, divorce, loss of employment, medicine/drug reliance etc) which was provided in confidence. Such mon-medical records may be removed since they were provided in confidence and not for general consumption.

Files may also need to be recovered from archives
especially if one is seeing the same doctor for many years. Recovering from archive can take some effort, time and indirect costs.

Notwithstanding this, the staff’s responsibility isn’t to compile files for patients which aren’t subject of a consultation. Consultations are subject to a payment (inc. Medicare rebates). These payments factor in file administration/management for the patient being seen. If there is no consultation to complie files for transfer, this is a cost to the doctors practice. These costs, including the doctors time for the above activities, takes time.

Time costs money, and why many professionals charge (reasonable) fees to cover time spent. Reasonable is the key and any professional needs to justify the fees when questioned.

This is exactly why a doctor would check records going out. It appears the administration staff which prepared the invoice may not have the necessary care and attention to take on those responsibilities as the doctor, as outlined above,

Possibly not, unless you were a regular patient requiring frequent consultations . As such, it might take a number of new patients to fill the ‘gap’, and this is something more likely to be noticed.

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This may/will be considered a breach of privacy by the Medical Practice, and as such should be referred to the Privacy Commissioner for your State/Territory (depending on which State as some only cover public organisations) or the Federal Office of the Australian Information Commissioner (OAIC).

The OAIC has a page about their areas of coverage:

From that page:

"

Private sector health service providers

The Privacy Act applies to all private sector health service providers anywhere in Australia. It doesn’t apply to state and territory public sector health service providers, such as public hospitals.

In NSW, Victoria and the Australian Capital Territory (ACT) private sector health service providers must comply with both Australian and state or territory privacy laws when handling health information.

Queensland, the Northern Territory and Tasmania have privacy legislation that applies only to their public sector, including public sector health service providers.

The link to health information:

"

What is health information?

Health information is any personal information about your health or disability. It includes information or opinion about your illness, injury or disability.

Some examples of health information include:

  • notes of your symptoms or diagnosis
  • information about a health service you’ve had or will receive
  • specialist reports and test results
  • prescriptions and other pharmaceutical purchases
  • dental records
  • your genetic information
  • your wishes about future health services
  • your wishes about potential organ donation
  • appointment and billing details
  • any other personal information about you when a health service provider collects it (my bolding)

Western Australia and South Australia do not have specific privacy legislation."

The link to health information also links to a further page about what is personal information that is covered under the Privacy Act:

"

What is personal information?

Personal information includes a broad range of information, or an opinion, that could identify an individual. What is personal information will vary, depending on whether a person can be identified or is reasonably identifiable in the circumstances.

For example, personal information may include:

  • an individual’s name, signature, address, phone number or date of birth (my bolding)
  • sensitive information
  • credit information
  • employee record information
  • photographs
  • internet protocol (IP) addresses
  • voice print and facial recognition biometrics (because they collect characteristics that make an individual’s voice or face unique)
  • location information from a mobile device (because it can reveal user activity patterns and habits)"
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